Public Safety Exposure Control & Prevention

Exposure Control & Prevention Resources

What You Need to Know About Infectious Exposures

Public safety personnel can be easily exposed on the job to blood and other potentially infectious body fluids. Emergency responders may perform urgent, invasive procedures on unstable patients, treat open wounds, stop bleeding, encounter used needles or be assaulted. These events put them at increased risk for contracting bloodborne pathogen infections, including hepatitis B virus, hepatitis C virus, and human immunodeficiency virus (HIV) infections.

What Is Considered an Exposure?

You can be exposed to bloodborne pathogens on the job by:

  • Contact of your eyes, nose, mouth, or broken skin with blood or other potentially infectious materials.
  • Needlesticks or cuts from sharp objects contaminated with blood or other body fluids.
  • Injury from needles or other sharp objects during pat-down searches.
  • Assaults—bites, cuts, or knife penetrations.

Other potentially infectious materials includes:

  • The following human body fluids: semen, vaginal secretions, cerebrospinal fluid, synovial fluid, pleural fluid, pericardial fluid, peritoneal fluid, amniotic fluid, saliva in dental procedures, any body fluid that is visibly contaminated with blood, and all body fluids in situations where it is difficult or impossible to differentiate between body fluids;
  • Any unfixed tissue or organ (other than intact skin) from a human (living or dead); and
  • HIV-containing cell or tissue cultures, organ cultures, and HIV- or HBV-containing culture medium or other solutions; and blood, organs, or other tissues from experimental animals infected with HIV or HBV.

Exposure Determination Tool Title

Unsure if you were exposed to an infectious disease?

Click here

to help you determine if you were potentially exposed and the next steps you should take.*

 

*Please note this is only a tool to assist you and your agency's existing exposure control plan. This tool is not intended to diagnose or replace professional medical advice. Always check with your designated infection control officer and Operational Medical Director for questions regarding exposure concerns and control procedures.

Protect Your Employees with an Exposure Control Plan


Your first line of defense against bloodborne pathogens.

A comprehensive bloodborne pathogens exposure prevention program will help protect your employees. One component of a bloodborne pathogens exposure prevention program is a written Exposure Control Plan.

These plans are required by the Occupational Safety and Health Administration (OSHA) Bloodborne Pathogens Standard. In addition, local regulations, employer policy, or collective bargaining agreements may call for such a program.

What is an Exposure Control Plan?

An Exposure Control Plan is the focal point of any bloodborne pathogens exposure prevention program. It details in writing your plan for reducing exposures to bloodborne pathogens and explains what steps to take when an exposure occurs. The Plan specifies all steps taken by your department to protect your workers.

Your Exposure Control Plan must be:

  • Specific to your department
  • Updated yearly
  • Accessible to workers

This information was adapted from the NIOSH's First Responders: Protect Your Employees with an Exposure Control Plan.

The following documents are intended to help agencies develop their infection control program and exposure notification and response policies and procedures:

  • Model Plans and Programs for the OSHA Bloodborne Pathogens and Hazard Communications Standards: OSHA’s bloodborne pathogens standard protects employees who work in occupations where they are at risk of exposure to blood or other potentially infectious materials. This publication includes a model exposure control plan to meet the requirements of the OSHA bloodborne pathogens standard and a model hazard communication program to meet the requirements of the hazard communication standard.

  • Guide To Managing An Emergency Service Infection Control Program: Since infection control requirements vary by agency type, local regulations, department size, etc., emergency response organizations cannot simply adopt a generic infection control program as their program. Therefore, this Guide is designed as a resource to help emergency response organizations tailor the requirements identified in regulations and standards to their own unique situations.

  • The National Fire Protection Association (NFPA) 1581: This standard provides the minimum requirements for a fire department infection control program to identify and limit the potential of an infectious exposure to fire department members during the performance of their assigned duties and within the fire department working and living environment. While NFPA 1581 was written for fire departments, the guidance it contains is universally applicable for all responders and can be easily translated to fit any department’s needs.

  • APIC's Guide to Infection Prevention in Emergency Medical Services: This guide is designed to help EMS system responders apply current scientific knowledge and best practices to improve targeted outcomes and enhance patient safety. Topics covered include: infection prevention standards, regulations, and best practices in patient and EMS system responder safety; instructions, examples, and tools to conduct surveillance and risk assessments; forms and templates for infection prevention education, training, and compliance monitoring; and emergency, disaster, and bioterrorism preparedness.

  • EMS Infectious Disease Playbook: The aim of this resource is to unify multiple sources of information in a single planning document addressing the full spectrum of infectious agents to create a concise reference resource for EMS agencies developing their service policies. The information contained in this playbook is intended as a planning resource, and should be incorporated into agency standard operating procedures and reviewed by the EMS medical director.

  • CDC - Protecting Healthcare Personnel: The resources on this page are intended to promote patient safety and increase the safety of the healthcare work environment from bloodborne infectious diseases.

  • Designing, Implementing & Evaluating a Sharps Injury Prevention Program: An effective sharps injury prevention program includes several components that must work in concert to prevent healthcare personnel from suffering needlesticks and other sharps-related injuries. This program plan is designed to be integrated into existing performance improvement, infection control, and safety programs.

  • Stop Sticks Campaign: Maintained by the National Occupational Research Agenda (NORA) Healthcare and Social Assistance Sector Council, the Stop Sticks campaign is a communication intervention aimed at raising awareness among health care workers about their risk of workplace exposure to bloodborne pathogens from needlesticks and other sharps related injuries.

Disease Exposure Control Planning Law and Policies

  • Virginia Regulations for Disease Reporting and Control: The Regulations for Disease Reporting and Control describe what diseases must be reported to the health department and the methods to use to report. Cases of disease have been reported to the Virginia health department since the early part of this century. Beginning in 1919, the Code of Virginia has required the State Board of Health to promulgate a list of diseases that must be reported. The enclosed regulations represent the Board’s latest response to this mandate.

Specific Infectious Disease Resources

  • Covid-19 Resources: Check out the Office of EMS's COVID-19 page to find the latest health and safety information for EMS providers.

Hazardous Materials Exposure Prevention and Response

  • Emergency Response Guidebook: U.S. Pipeline and Hazardous Materials Safety Administration's Emergency Response Guidebook provides first responders with a go-to manual to help deal with hazmat transportation accidents during the critical first 30 minutes.

  • Nerve Agent Information for EMS: This document provides a quick refresher on standard protocols for recognizing, treating, and protecting yourself from nerve agent exposures.

  • PPE Requirments: OSHA's "Best Practices for Protecting EMS Responders during Treatment and Transport of Victims of Hazardous Substance Releases" details how to best protect providers transporting patients who have been exposed to hazardous substances.

Designated Infection Control Officer Training

*Links to non-Virginia Commonwealth or non-federal websites on this page do not constitute as an endorsement by the Commonwealth of Virginia or the U.S. government, or any of its employees, of the information and/or products presented on those sites.

**As of December 31, 2019, the Virginia Office of EMS (OEMS) does not identify, approve, or endorse specific Infection Control Officer educational programs. Virginia licensed EMS agencies may select a training program of their choice to ensure their agency's DICO has received training that is compliant with OSHA Bloodborne Pathogens Standard 29 CFR 1910.1030 and any other federal regulation(s) that may apply.  Click here to learn more.

***Under Construction***

Recommended Vaccine Resources

Laws and Regulations Concerning Healthcare Personnel Vaccinations

  • Federal regulations through the Occupational Safety and Health Administration (OSHA)’s Bloodborne Pathogen Standard 1910.1030(f)require employers to offer the hepatitis B vaccination to all employees who have anticipated contact with blood and other potentially infectious materials. The vaccination should be offered at no cost, after the employee has received training, and within 10 days of initial assignment to a job where there is occupational exposure, unless the worker has previously received the vaccine series, antibody testing has revealed the worker is immune or the vaccine is contraindicated for medical reasons.
  • The vaccination series must be provided in accordance with the recommendations of the U.S. Public Health Service current at the time of the vaccination. This includes follow-up testing one to two months after the completion of the three-dose vaccination series to test for antibody to hepatitis B surface antigen.
  • OSHA Fact Sheet on Hepatitis B Vaccination Protection
  • The Virginia Occupational Safety and Health (VOSH) Program has adopted the federal OSHA standard and has incorporated it by reference into the Virginia Administrative Code (16VAC25-90-1910).  When Virginia adopts federal OSHA standards such as the 1910.1030 Bloodborne Pathogen Standard, they become state law and the VOSH Program has the authority to enforce them in public and private sector workplaces.
  • Besides hepatitis B vaccination as discussed above, there are no other state laws or regulations requiring vaccinations specifically for HCP in the Commonwealth of Virginia.
  • As a best practice, immunization coverage assessments should be performed upon hire and annually to ensure HCP are immunized appropriately.
  • Workers may be subject to the vaccine requirements put in place by their respective employers.
  • Students, interns and trainees in healthcare settings may be subject to the vaccine requirements established by their college/university or training program. Vaccine recommendations may reflect guidance from The American College Health Association.
  • HCP without documented vaccination or immunity may be furloughed at the recommendation of the health department and/or employer in the event of an outbreak or disease exposure of public health importance.
  • Some State regulations provide for facilities to establish infection control policies that may include HCP vaccination.  Here are some examples:
  • State regulations 12VAC5-410-490 provide that hospitals shall have an infection control committee to “develop, periodically evaluate, and revise as needed, infection control policies, procedures, and techniques” that  “shall include, but are not limited to, appropriate employee health screening and immunization.”
  • State regulations 22VAC40-72-90 provides that assisted living facilities “shall establish and maintain an infection control program” that is designed to “prevent the development and transmission of disease and infection.”

About Virginia's Exposure Control & Prevention Initiative

Exposure to infectious diseases is a serious threat to first responders. At the request of the General Assembly of Virginia, a workgroup was established to improve the Commonwealth's response to exposure-prone incidents involving public safety employees. The goal of the workgroup is to develop and establish unified exposure control and prevention plans, guidance, and resources for all public safety personnel. The workgroup consists of representatives from law enforcement agencies, fire departments and companies, emergency medical services agencies, and other appropriate entities.

If you have any information or suggestions you would like to share with the workgroup, please contact Karen Owens, Emergency Operations Manager, at Karen.Owens@vdh.virginia.gov.